When the subject of placebos enters into the conversation, what’s the perception? That the brain can fool the body? That doctors sometimes use it to convince the patient that a substance or pill will change the existing conditions of the body? Are there ethics guiding the use of placebos?
The 60 Minutes interview concerning placebos brought to the public an awareness of the existence of the placebo and the effect it has on the body. This high-profile and explosive television program with Leslie Stahl and Dr. Irving Kirsch, Associate Director of the Placebo Studies Program at Harvard Medical School, not only validated the effect placebos can have but also opened the door to challenge the use of antidepressant drugs that may have negative side effects. As researchers, physicians, and members of the public express more interest in the use of placebos to treat patients, rather than just as research tools, what constraints or guidance for their use are in place?
The PLoS One Journal article “British Doctors Increasingly Banking on ‘Placebo Effect’” describes the inconsistent guidelines and usage surrounding placebos and makes the startling statement that more than three-fourths of British doctors surveyed in a recent study prescribed treatments at least once a week that they knew probably wouldn’t work. Recently the British medical establishment has taken a stance against placebos by declaring them unethical. Yet, one key reason the British physicians use placebos is pressure from patients who want something to cure a perceived issue.
On the other hand, the American Medical Association’s stance on placebos is that physicians may only use them when the patient has been made aware. A U.S.–based study found that about half of American doctors give their patients treatments that probably won’t work, but will set their patent’s mind at ease.
What does a placebo do? Under the definition that physicians use of setting a patient’s mind at ease, a placebo could be considered prayer. In an article, “Prayer and Placebo,” David Sack states, “Prayer at the very least is a placebo and placebos have been shown time and time again to be effective.”
However, to accept prayer as a placebo would be to ignore many studies that indicate prayer is much more than a placebo. In the Journal of Holistic Nursing article “Prayer and Healing” Christina E. Hughes states, “There sometimes exists a facet of prayer and healing that defies rational explanation and seems to suggest the existence of a higher power. A case is presented that explores assistance from a higher power as a potential explanation for the healing.”
The Bible supports the statement of the effectiveness of prayer with, “And all things, whatsoever ye shall ask in prayer, believing, ye shall receive.” From personal experience, I’ve found prayer and meditation puts my mind at ease and maintains my health during physical or stressful conditions. Many others are also finding the benefit of prayer. An earlier NIH study indicated that the public was very interested in alternative and complementary therapies, with prayer being the most used at 48%. It will be interesting to see where public demand leads the medical world and the responses of physicians to this form of treatment.
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